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目的研究乌司他丁能否减轻化疗的不良反应并探讨其机制。方法将40例胃肠道肿瘤术后患者随机分成乌司他丁治疗组和空白对照组。所有患者在化疗前1d及下次化疗前空腹抽血检测白介素6(IL-6)和肿瘤坏死因子α(TNF-α)。治疗组患者每天化疗前滴注乌司他丁15万U,连续5d;对照组患者每天化疗前滴注生理盐水;对比两组患者的不良反应发生率和治疗前后IL-6、TNF-α水平的变化。结果两组患者临床病理特征无差别。对照组白细胞下降、皮肤毒性、脱发的发生率比治疗组高,两组比较分别为P=0.049,P=0.026和P=0.032。治疗组患者化疗后IL-6的水平下降,与化疗前比较,P=0.033;TNF-α的水平化疗前后无明显变化。对照组治疗前后IL-6及TNF-α的水平均无明显变化。结论乌司他丁能减轻化疗后的一些常见不良反应,其机制可能是通过降低炎症因子IL-6的水平而发挥作用的。
Objective To investigate whether ulinastatin can reduce adverse reactions of chemotherapy and explore its mechanism. Methods Forty patients with gastrointestinal cancer were randomly divided into ulinastatin group and blank control group. All patients were tested for IL-6 and TNF-α on the day before chemotherapy and before the next chemotherapy. The patients in the treatment group were treated with 150,000 U of ulinastatin intravenously once a day for 5 days. The patients in the control group were treated with saline before chemotherapy. The incidence of adverse reactions and the levels of IL-6 and TNF-α in the two groups were compared The change. Results There was no difference in clinicopathological features between the two groups. The incidence of leukopenia, skin toxicity and hair loss were higher in the control group than in the treatment group, P = 0.049, P = 0.026 and P = 0.032, respectively. The level of IL-6 in the treatment group decreased after chemotherapy, P = 0.033 compared with that before chemotherapy; the level of TNF-α did not change significantly before and after chemotherapy. The levels of IL-6 and TNF-α in the control group before and after treatment did not change significantly. Conclusion Ulinastatin can reduce some of the common adverse reactions after chemotherapy, the mechanism may be through the reduction of inflammatory cytokines IL-6 levels play a role.